Rustic Roots Counseling Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RUSTIC ROOTS COUNSELING CENTER, LLC

Practice address

17541 Eagles Perch Dr
Prairieville, LA 70769-6069

Phone

(337) 254-2629

NPI assigned

Aug 18, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shereva S Lewis, LPCNPI 1831558600

Title

Owner

Phone

(337) 254-2629

Specialties & licenses 1

Addresses

Other names 1

• Rustic Roots Counseling Center, LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shereva Lewis, MA, LPC

  • Professional Counselor
  • Denham Springs, LA
  • NPI 1831558600
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1306512686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17541 EAGLES PERCH DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707696069",
            "telephone_number": "337-254-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17541 EAGLES PERCH DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707696069",
            "telephone_number": "337-254-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTIC ROOTS COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SHEREVA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-254-2629",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rustic Roots Counseling Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reginald J. Ross, M.D.
• Jennifer Rostafin, FNP
• Jamie Lynn Roussel
• Bre'Anna Ruffin
• Jessica Marie Rush
• Tyler Rutland
• Erin Hebert Ryan
• Alaine Ryder, LPC
• Georgette Sananikone
• Kymani Sanders

• Mental Health Clinic/Center (Including Community Mental Health Center) in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.